Pityriasis Rosea

Pityriasis Rosea

Q. 1 Pityriasis rosea is a:
 A Self limiting disease
 B Chronic relapsing disease
 C Auto irmnune disease
 D Caused by dermatophyte
Q. 1 Pityriasis rosea is a:
 A Self limiting disease
 B Chronic relapsing disease
 C Auto irmnune disease
 D Caused by dermatophyte
Ans. A

Explanation:

Pityriasis rosea is a disease of unknown etiology more commonly seen in spring and consists of papulosquamous eruptions. The disease is self limiting and usually lasts for 3 to 8 weeks. Epidemiology
• Young age (10-43 years) more commonly affected. F>M
• Etiology – Unknown, HHV- may have a role Clinical features
The first manifestation is development of 2-6 cm annular lesion k.a. HERALD PATCH with fine COLLARETTE scales at periphery. Lesion are usually pruritic (may be absent in 25%). Lesions are usually confined to trunk and proximal aspects of arms and legs with characteristic distribution with the long axis of the oval lesion following the line of cleavage in a” CHRISTMAS TREE” PATTERN. Treatment
Oral anti histaminic or topical anti pruritic agent for symptomatic relief. UVB phototherapy or natural sunlight exposure may give relief if started in first week of eruption.


Q. 2

Hanging curtain sign seen in? 

 A

Pityriasis rosea

 B

Pityriasis Versicolor

 C

Pityriasis rubra pilaris

 D

Pityriasis lichenoides chronica

Q. 2

Hanging curtain sign seen in? 

 A

Pityriasis rosea

 B

Pityriasis Versicolor

 C

Pityriasis rubra pilaris

 D

Pityriasis lichenoides chronica

Ans. A

Explanation:

Pityriasis rosea 

REF: Dermatology. 1995; 190(3): 252. PubMed PMID: 7599393, Clinical Pediatric Dermatology – By Thappa page 104

PITYRIASIS ROSEA

The primary eruption, herald patch (Mother spot) is a single oval or round patch with a central wrinkled salmon colored area and a darker peripheral zone separated by a “collarette of scales” (when stretched across the long axis, the scales tends to fold across the line of stretch, the so called Hanging curtain sign).


Q. 3

Lesions of pityriasis rosea are distributed mostly on the:

 A

Face

 B

Trunk

 C

Scalp

 D

Palms and soleus

Q. 3

Lesions of pityriasis rosea are distributed mostly on the:

 A

Face

 B

Trunk

 C

Scalp

 D

Palms and soleus

Ans. B

Explanation:

Ans:B.)Trunk


Q. 4

A 25 year old male presents with multiple erythematous annular plaques with peripheral collarette of scales arranged predominantly over trunk. What is the most probable diagnosis?

 A

Pityriasis versicolor

 B

Pityriasis rubra pilaris

 C

Pityriasis rosea

 D

Pityriasis lichenoides chonica

Q. 4

A 25 year old male presents with multiple erythematous annular plaques with peripheral collarette of scales arranged predominantly over trunk. What is the most probable diagnosis?

 A

Pityriasis versicolor

 B

Pityriasis rubra pilaris

 C

Pityriasis rosea

 D

Pityriasis lichenoides chonica

Ans. C

Explanation:

Pityriasis Rosea is a self limiting papulosquamous dermatoses of unknown aetiology characterised by Herald patch, annular plaque with peripheral collarette of scales on the trunk and secondary lesions arranged in Christmas tree/fir tree appearance.

Treatment is usually symptomatic. It resolves in about 8-10 weeks.

Ref: Illustrated Synopsis of Dermatology and STD’s By Neena Khanna, Pages 50-51


Q. 5

A teenager presented with a skin lesion which appeared as thin oval plaque with a fine collarette of scale located inside the periphery of the plaque. Pityriasis rosea is diagnosed. All of the following are characteristic of pityriasis rosea, EXCEPT:

 A

Lower respiratory infection

 B

Herald patch

 C

Moderate itching

 D

Low grade fever

Q. 5

A teenager presented with a skin lesion which appeared as thin oval plaque with a fine collarette of scale located inside the periphery of the plaque. Pityriasis rosea is diagnosed. All of the following are characteristic of pityriasis rosea, EXCEPT:

 A

Lower respiratory infection

 B

Herald patch

 C

Moderate itching

 D

Low grade fever

Ans. A

Explanation:

Pityriasis Rosea (PR):

  • Common acute papulosquamous eruption normally lasting 4–10 weeks.
  • Most often begins as a single 2- to 4-cm thin oval plaque with a fine collarette of scale located inside the periphery of the plaque (“herald patch”).
  • Similar-appearing, but smaller, lesions appear several days to weeks later, typically distributed along the lines of cleavage on the trunk (“Christmas tree” pattern).
  • Usually asymptomatic, sometimes pruritic with mild flu-like symptoms.
  • Occurs most commonly in teenagers and young adults.
  • Probably a viral exanthem associated with reactivation of human herpes virus (HHV)-7 and sometimes HHV-6.
  • Treatment is usually supportive, although midpotency topical corticosteroids can reduce pruritus; high-dose acyclovir for 1 week may hasten recovery.
 
Ref: Blauvelt A. (2012). Chapter 42. Pityriasis Rosea. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick’s Dermatology in General Medicine, 8e.

Q. 6

‘Fir-tree’ type of distribution is seen in‑

 A

Pityriasis Rosea

 B

Psoriasis

 C

Measles

 D

Secondary syhilis

Q. 6

‘Fir-tree’ type of distribution is seen in‑

 A

Pityriasis Rosea

 B

Psoriasis

 C

Measles

 D

Secondary syhilis

Ans. A

Explanation:

A. i.e. Pityriasis rosea


Q. 7

Which viral association is found in pityriasis rosea :

 A

HHV 7

 B

CMV

 C

Vericella Zoster

 D

EBV

Q. 7

Which viral association is found in pityriasis rosea :

 A

HHV 7

 B

CMV

 C

Vericella Zoster

 D

EBV

Ans. A

Explanation:

A. i.e. HHV-7


Q. 8

Etiology of Pityriasis rosea is:   

March 2012

 A

M. furfur

 B

Herpes virus

 C

Autoimmune

 D

Staphylococcus

Q. 8

Etiology of Pityriasis rosea is:   

March 2012

 A

M. furfur

 B

Herpes virus

 C

Autoimmune

 D

Staphylococcus

Ans. B

Explanation:

Ans: B i.e. Herpes virus

Skin conditions and causative agent

  • Etiological factor for pityriasis versicolor is Malassezia furfur (earlier classified as pityrosporum ovale), a commonest yeast
  • Etiology of pityriasis rosea is unkown. A virus (Human herpes Virus-7 more frequently, HHV-6 less frequently) has often been incriminated
  • Pemphigus vulgaris is an autoimmune disease, characterized by acantholysis, induced by deposition of IgG autoantibodies in an intercellular area of epidermis
  • Staphylococcus aureus, present in either a distant cutaneous focus or in an extracutaneous focus releases an exfoliative toxin that results in peeling of skin (staphylococcal scalded skin syndrome).

Q. 9

Christmas tree appearance in skin is seen in ‑

 A

Pityriasis rosea

 B

Pityriasisrubrapilaris

 C

Psoriasis

 D

Vitiligo

Q. 9

Christmas tree appearance in skin is seen in ‑

 A

Pityriasis rosea

 B

Pityriasisrubrapilaris

 C

Psoriasis

 D

Vitiligo

Ans. A

Explanation:

Ans. is ‘a’ i.e., Pityriasis rosea 

Pityriasis rosacea

  • P. rosea is a common scaly disorder, occuring usually in children and young adults (10-35 years).
  • Characterized by round/oval pink brown patches with a superficial, centrifugal scale, distributed over trunk in a Christmas tree pattern.
  • The disease is thought to be viral disease, is self limiting, and subsides in 6-12 weeks.
  • The exact etiology is not known, but it is considered to be a viral disease; Human Herpes virus 6 (HHV 6) and Human Herpes virus 7 (HHV 7) may play a role.

Clinical manifestations of P. rosea

  • The disease starts with an upper respiratory prodrome or a mild flu.
  • After 1-2 weeks, Annular erythmatous plaque appears on trunk that is referred to as mother patch or herald patch.
  • Over the next 1-2 weeks, fresh patch appear all over the trunk, in a Christmas tree configuration or Fir tree Configration.
  • The lesions are pinkish in white skin, hence the name rosea.
  • However, on the dark Indian skin the lesions are skin coloured or brown.
  • The most characteristic clue for the diagnosis is the presence of a fine scale at the edge of the lesion referrred to as centrifugal scale or collarette scales or cigarette paper scales.

Lesions subside with hyperpigmentation.

  • Trunk is involved predominantly, Sometimes (in 20% of patients) lesions occur predominantly on extremities and neck (inverse pattern).


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